Longitudinal assessment of PTSD and illicit drug use among male and female OEF-OIF veterans.

Longitudinal assessment of PTSD and illicit drug use among male and female OEF-OIF veterans.
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DOI:
10.1016/j.addbeh.2021.106870
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发表时间:
2021-07
影响因子:
4.4
通讯作者:
Keane, Terence M.
Keane, Terence M.
中科院分区:
医学2区
文献类型:
--
作者:
Livingston, Nicholas A.;Lee, Daniel J.;Mahoney, Colin T.;Farmer, Stacey L.;Cole, Travis;Marx, Brian P.;Keane, Terence M.

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随着时间的推移,创伤后应激障碍 (PTSD) 和药物滥用既有方向性(“自我药疗”)又有相辅相成的关联。关于 PTSD 和物质使用随时间同时发生的性别差异的研究仍然有限,并且主要集中在酒精使用上;关于创伤后应激障碍和非法药物使用同时发生的情况,尤其是在退伍军人中,人们知之甚少。随着军队中女性比例的扩大,我们认为有必要更加关注性别差异。我们使用来自 9/11 后退伍军人的大型全国纵向登记的两波数据,对 PTSD 症状和药物使用问题进行了交叉滞后面板分析。参与者包括 608 名男性和 635 名女性(N = 1243;Mage = 42.3;75.2% 白人),他们在 T1 和 15-37 个月后的 T2 时完成了自我报告的 PTSD 和吸毒问题问卷。总体而言,退伍军人男性报告了更严重的吸毒和相关问题,但在吸毒退伍军人中,创伤后应激障碍和吸毒问题之间的横截面相关性最强。在我们的交叉滞后模型中,我们发现 PTSD 症状可以预测退伍军人未来的吸毒问题,而吸毒问题可以预测女性未来的 PTSD 症状严重程度。这些结果支持退伍军人的自我药疗途径,但不支持女性,对她们来说,随着时间的推移,吸毒问题可能会延长或加剧 PTSD 症状的严重程度。这些结果与一些新出现的证据一致,但也为控制男性与女性 PTSD 纵向过程和药物使用问题的功能关联提供了新的见解。
Posttraumatic stress disorder (PTSD) and substance use share both directional (“self-medication”) and mutually-reinforcing associations over time. Research on gender differences regarding the co-occurrence of PTSD and substance use over time remains limited and largely focused on alcohol use; less is known regarding the co-occurrence of PTSD and illicit drug use, especially among veteran men vs. women. As the proportion of women in the military expands, we believe a greater focus on gender differences is warranted. We conducted a cross-lagged panel analysis of PTSD symptoms and drug use problems using two waves of data from a large, nationwide longitudinal registry of post-9/11 veterans. Participants included 608 men and 635 women (N = 1243; Mage = 42.3; 75.2% White) who completed self-report PTSD and drug use problem questionnaires at T1 and again at T2 15–37 months later. Veteran men reported more severe drug use and related problems overall, yet the cross-sectional correlation between PTSD and drug use problems was strongest among drug using veteran women. In our cross-lagged models, we found that PTSD symptoms predicted future drug use problems among veteran men, whereas drug use problems predicted future PTSD symptom severity among women. These results support the self-medication pathway among veteran men but not women, for whom drug use problems might prolong or exacerbate PTSD symptom severity over time. These results are consistent with some emerging evidence but also provide novel insight into functional associations governing the longitudinal course of PTSD and drug use problems for men vs. women.
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